Suchergebnisse

Objective: We examined multimorbidity among foreign-born adults in the United States. This population may be particularly affected by chronic conditions and limited health care access.Design: Longitudinal cohort.Setting: United States.Participants: Foreign-born adults at the point of legal permanent residency.Methods: We estimated the prevalence of multimorbidity and patterns over time. Data are from the New Immigrant Survey (NIS), a nationally representative study of adult immigrants at green card status in 2003 (N=8,174) and reinterview in 2008.Main Outcome Measures: Multimorbid­ity defined as two or more of eight chronic conditions (hypertension, diabetes, obesity, arthritis, stroke, cancer, chronic lung dis­ease, and heart problems).Results: The prevalence of multimorbid­ity was 6% in 2003, and 12% in 2008. The most common condition dyad at both time points was hypertension-obesity; the largest increase over time was in combinations that included hypertension, diabetes, and obesity. The odds of having multimorbidity compared to no chronic conditions were higher among older immigrants and those who had seen a doctor in the past year. The odds of gaining one chronic condition over a 5-year period increased with age; 45-65 years: OR 2.8[CI 2.3,3.5]; aged ≥65 years: OR 3.2 CI[2.2,4.7].Conclusions: The prevalence of multimor­bidity among immigrants was lower than the prevalence in the overall US population of the same age, consistent with studies show­ing an immigrant health advantage. Ethn Dis. 2022;32(3):213-222; doi:10.18865/ed.32.3.213

Purpose: This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US. Design: Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children's Health. Setting: US, national. Subjects: Children ages 10-17 years (n = 34,640) Measures: Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts. Analysis: Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics. Results: An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time. Conclusion: Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.

AbstractParental expectations about the companionship and assistance they will receive in later life from their children are key considerations in family formation decisions. We explore patterns of parents' investment and the support and contact they receive from adult children in Egypt, where fertility is falling and sources of support at all life stages are in flux. Using data from a survey of older adults in Ismailia governorate, we consider parents' past investments in childbearing, child survival, and children's education and marriage, as well as recent assistance to adult children via housing, care for grandchildren, gifts, and money. The returns from children considered include economic assistance, instrumental support, and visits. Most parental investments are associated with frequent visits from children. The assistance children provide to parents is gendered: sons tend to provide economic transfers, whereas daughters tend to provide instrumental help. A greater number of surviving children is most strongly associated with parents' receipt of multiple types of later-life returns. Investments in children's education and marriage are not associated with assistance, but recent assistance to children—especially economic transfers and provision of housing—is associated with receiving instrumental assistance from adult children.

Using a national district-level dataset of India composed of information on investments in primary schooling (data from the District Information Survey for Education [DISE, 2007/8]) and information on demographic characteristics of elected officials (data from the Election Commission of India [ECI, 2000/04]), we examined the relationship between women's representation in State Legislative Assembly (SLA) seats and district-level investments in primary schooling. We used OLS regressions adjusting for confounders and spatial autocorrelation, and estimated separate models for North and South India. Women's representation in general SLA seats typically was negatively associated with investments in primary-school amenities and teachers; women's representation in SLA seats reserved for under-represented minorities, i.e., scheduled castes and scheduled tribes, typically was positively associated with investments in primary schooling, especially in areas addressing the basic needs of poor children. Women legislators' gender and caste identities may shape their decisions about redistributive educational policies.

Purpose: To examine associations of adolescent sugar-sweetened beverage (SSB) intake with parent SSB intake and parent and adolescent knowledge of SSB-related health risks. Design: Quantitative, cross-sectional. Setting: 2014 SummerStyles survey. Subjects: Nine hundred and ninety parent and adolescent (12-17 years) pairs. Measures: The outcome was self-reported adolescent intake (0, >0 to <1, or ≥1 time/day) of SSBs (soda, fruit drinks, sports/energy drinks, other SSBs). The exposures were self-reported parent SSB intake (0, >0 to <1, ≥1 to <2, or ≥2 times/day) and parent and adolescent knowledge of SSB-related health risks (weight gain, diabetes, and dental caries). Analysis: Separate multinomial logistic regression models were used to estimate adjusted odds ratios (aORs) for adolescent SSB intake ≥1 time/day (ref: 0 times/day), according to (1) parent SSB intake and (2) parent and (3) adolescent knowledge. Results: About 31% of adolescents consumed SSBs ≥1 time/day, and 43.2% of parents consumed SSBs ≥2 times/day. Adolescent and parent knowledge that SSB intake is related to health conditions ranged from 60.7% to 80.4%: weight gain (75.0% and 80.4%, respectively), diabetes (60.7% and 71.4%, respectively), and dental caries (77.5% and 72.9%, respectively). In adjusted models, adolescent SSB intake ≥1 time/day was associated with parent intake ≥2 times/day (aOR = 3.30; 95% confidence interval = 1.62-6.74) but not with parent or adolescent knowledge of health risks. Conclusion: Parental SSB intake may be an important factor in understanding adolescent behavior; knowledge of SSB-related health conditions alone may not influence adolescent SSB behavior.

As of June 2017, 65.6 million people worldwide have been forcibly displaced due to war, persecution, or to seek better social or economic conditions for themselves and their families. Migration and exposure to new environments may have implications for health. This case study describes exploratory data collection among foreign-born people in Belgium, a leading immigrant destination. We conducted community-based data collection, focusing on neighborhoods and spaces in Brussels with high numbers of immigrants and asylum seekers. The lessons learned are presented here as an example of preliminary research with a fluid population. We highlight some of the challenges in recruiting and ethical considerations we encountered.

BACKGROUND: In India, the prevalence of overweight and obesity has increased rapidly in recent decades. Given the association between overweight and obesity with many non-communicable diseases, forecasts of the future prevalence of overweight and obesity can help inform policy in a country where around one sixth of the world's population resides. METHODS: We used a system of multi-state life tables to forecast overweight and obesity prevalence among Indians aged 20-69 years by age, sex and urban/rural residence to 2040. We estimated the incidence and initial prevalence of overweight using nationally representative data from the National Family Health Surveys 3 and 4, and the Study on global AGEing and adult health, waves 0 and 1. We forecasted future mortality, using the Lee-Carter model fitted life tables reported by the Sample Registration System, and adjusted the mortality rates for Body Mass Index using relative risks from the literature. RESULTS: The prevalence of overweight will more than double among Indian adults aged 20-69 years between 2010 and 2040, while the prevalence of obesity will triple. Specifically, the prevalence of overweight and obesity will reach 30.5% (27.4%-34.4%) and 9.5% (5.4%-13.3%) among men, and 27.4% (24.5%-30.6%) and 13.9% (10.1%-16.9%) among women, respectively, by 2040. The largest increases in the prevalence of overweight and obesity between 2010 and 2040 is expected to be in older ages, and we found a larger relative increase in overweight and obesity in rural areas compared to urban areas. The largest relative increase in overweight and obesity prevalence was forecast to occur at older age groups. CONCLUSION: The overall prevalence of overweight and obesity is expected to increase considerably in India by 2040, with substantial increases particularly among rural residents and older Indians. Detailed predictions of excess weight are crucial in estimating future non-communicable disease burdens and their economic impact. ; This study was supported in part by the Victorian Government's OIS Program, the Australian National Health and Medical Research Council (NHMRC Project no. 1122744), the Murdoch Children's Research Institute, and the Royal Children's Hospital Foundation (grant no. 2017-896). GA was supported by an NHMRC Early Career Fellowship (no. 1090462). MI was supported by the Munz Chair of Cardiovascular Prediction and Prevention. This study acknowledges the use of the following UK JIA cohort collections: The Biologics for Children with Rheumatic Diseases (BCRD) study (funded by Arthritis Research UK Grant 20747). The British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR-ETN) (funded by a research grant from the British Society for Rheumatology (BSR). BSR has previously also received restricted income from Pfizer to fund this project). Childhood Arthritis Prospective Study (CAPS) (funded by Versus Arthritis, grant reference number 20542), Childhood Arthritis Response to Medication Study (CHARMS) (funded by Sparks UK, reference 08ICH09, and the Medical Research Council, reference MR/M004600/1), United Kingdom Juvenile Idiopathic Arthritis Genetics Consortium (UKJIAGC). Genotyping of the UK JIA case samples were supported by the Versus Arthritis grants reference numbers 20385 and 21754. This research was funded by the NIHR Manchester Biomedical Research Centre and supported by the Manchester Academic Health Sciences Centre (MAHSC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We would like to acknowledge the assistance given by IT Services and the use of the Computational Shared Facility at The University of Manchester. Finally, the CHOP data used were funded by an Institute Development Fund to the CAG center from The Children's Hospital of Philadelphia and by NIH grant, U01-HG006830, from the NHGRI-sponsored eMERGE Network.

This study examined coronavirus disease 2019 (COVID-19) prevention knowledge among community residents in Eastern Ethiopia to support public health interventions and vaccination coverage. A cross-sectional survey in August-September 2021 recruited 880 participants from households in a Health and Demographic Surveillance System (HDSS) in Harari and Oromia, Ethiopia. Participants were randomly selected and interviewed in person using tablets and a standardized questionnaire. Principal components analysis was used to create a score representing COVID-19 prevention knowledge. Quasi-Poisson regression was used to examine associations between demographic characteristics and COVID-19 prevention knowledge. The survey also assessed awareness of community/government COVID-19 prevention measures and healthcare services for under-5 children and pregnant women. The most cited COVID-19 prevention measures were handwashing with soap (91.5%) and wearing facemasks (89.2%); least mentioned were avoiding travel (22.2%) and wearing medical gloves (20.3%). Commonly recognized community/government measures included school closures (77.0%), avoiding gatherings (75.2%), and staying home (62.3%). Adjusted analyses demonstrated higher COVID-19 prevention knowledge among rural participants, those aged ≥65 years (reference: <25), with secondary education (reference: no education), with monthly income of ≥2,001 Birr (reference: 0–1,200), and were farmers, domestic/subsistence workers, or government employees (reference: unemployed). Knowledge was lower among households with ≥5 household members. Of households with under-5 children and pregnant women, 9.4% and 12.3% missed medical care visits since mid-March 2020 consequent to the pandemic. Public health interventions to reduce COVID-19 transmission rely on risk perception and knowledge. Understanding these factors can help Ethiopian authorities design effective health education programs to control community and household SARS-CoV-2 transmission.